Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity

Abstract Hypertension is a recognized comorbidity for COVID-19. The association of antihypertensive medications with outcomes in patients with hypertension is not fully described. However, angiotensin-converting enzyme 2 (ACE2), responsible for host entry of the novel coronavirus (SARS-CoV-2) leadin...

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Autores principales: Majid Jaberi-Douraki, Emma Meyer, Jim Riviere, Nuwan Indika Millagaha Gedara, Jessica Kawakami, Gerald J. Wyckoff, Xuan Xu
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Publicado: Nature Portfolio 2021
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spelling oai:doaj.org-article:88722c0702ca410cafac6d604c2cd4d12021-12-02T17:45:11ZPulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity10.1038/s41598-021-92734-72045-2322https://doaj.org/article/88722c0702ca410cafac6d604c2cd4d12021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-92734-7https://doaj.org/toc/2045-2322Abstract Hypertension is a recognized comorbidity for COVID-19. The association of antihypertensive medications with outcomes in patients with hypertension is not fully described. However, angiotensin-converting enzyme 2 (ACE2), responsible for host entry of the novel coronavirus (SARS-CoV-2) leading to COVID-19, is postulated to be upregulated in patients taking angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs). Here, we evaluated the occurrence of pulmonary adverse drug events (ADEs) in patients with hypertension receiving ACEIs/ARBs to determine if disparities exist between individual drugs within the respective classes using data from the FDA Spontaneous Reporting Systems. For this purpose, we proposed the proportional reporting ratio to provide a statistical summary for the commonality of an ADE for a specific drug as compared to the entire database for drugs in the same or other classes. In addition, a statistical procedure, multiple logistic regression analysis, was employed to correct hidden confounders when causative covariates are underreported or untrusted to correct analyses of drug-ADE combinations. To date, analyses have been focused on drug classes rather than individual drugs which may have different ADE profiles depending on the underlying diseases present. A retrospective analysis of thirteen pulmonary ADEs showed significant differences associated with quinapril and trandolapril, compared to other ACEIs and ARBs. Specifically, quinapril and trandolapril were found to have a statistically significantly higher incidence of pulmonary ADEs compared with other ACEIs as well as ARBs (P < 0.0001) for group comparison (i.e., ACEIs vs. ARBs vs. quinapril vs. trandolapril) and (P ≤ 0.0007) for pairwise comparison (i.e., ACEIs vs. quinapril, ACEIs vs. trandolapril, ARBs vs. quinapril, or ARBs vs. trandolapril). This study suggests that specific members of the ACEI antihypertensive class (quinapril and trandolapril) have a significantly higher cluster of pulmonary ADEs.Majid Jaberi-DourakiEmma MeyerJim RiviereNuwan Indika Millagaha GedaraJessica KawakamiGerald J. WyckoffXuan XuNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Majid Jaberi-Douraki
Emma Meyer
Jim Riviere
Nuwan Indika Millagaha Gedara
Jessica Kawakami
Gerald J. Wyckoff
Xuan Xu
Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity
description Abstract Hypertension is a recognized comorbidity for COVID-19. The association of antihypertensive medications with outcomes in patients with hypertension is not fully described. However, angiotensin-converting enzyme 2 (ACE2), responsible for host entry of the novel coronavirus (SARS-CoV-2) leading to COVID-19, is postulated to be upregulated in patients taking angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs). Here, we evaluated the occurrence of pulmonary adverse drug events (ADEs) in patients with hypertension receiving ACEIs/ARBs to determine if disparities exist between individual drugs within the respective classes using data from the FDA Spontaneous Reporting Systems. For this purpose, we proposed the proportional reporting ratio to provide a statistical summary for the commonality of an ADE for a specific drug as compared to the entire database for drugs in the same or other classes. In addition, a statistical procedure, multiple logistic regression analysis, was employed to correct hidden confounders when causative covariates are underreported or untrusted to correct analyses of drug-ADE combinations. To date, analyses have been focused on drug classes rather than individual drugs which may have different ADE profiles depending on the underlying diseases present. A retrospective analysis of thirteen pulmonary ADEs showed significant differences associated with quinapril and trandolapril, compared to other ACEIs and ARBs. Specifically, quinapril and trandolapril were found to have a statistically significantly higher incidence of pulmonary ADEs compared with other ACEIs as well as ARBs (P < 0.0001) for group comparison (i.e., ACEIs vs. ARBs vs. quinapril vs. trandolapril) and (P ≤ 0.0007) for pairwise comparison (i.e., ACEIs vs. quinapril, ACEIs vs. trandolapril, ARBs vs. quinapril, or ARBs vs. trandolapril). This study suggests that specific members of the ACEI antihypertensive class (quinapril and trandolapril) have a significantly higher cluster of pulmonary ADEs.
format article
author Majid Jaberi-Douraki
Emma Meyer
Jim Riviere
Nuwan Indika Millagaha Gedara
Jessica Kawakami
Gerald J. Wyckoff
Xuan Xu
author_facet Majid Jaberi-Douraki
Emma Meyer
Jim Riviere
Nuwan Indika Millagaha Gedara
Jessica Kawakami
Gerald J. Wyckoff
Xuan Xu
author_sort Majid Jaberi-Douraki
title Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity
title_short Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity
title_full Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity
title_fullStr Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity
title_full_unstemmed Pulmonary adverse drug event data in hypertension with implications on COVID-19 morbidity
title_sort pulmonary adverse drug event data in hypertension with implications on covid-19 morbidity
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/88722c0702ca410cafac6d604c2cd4d1
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AT nuwanindikamillagahagedara pulmonaryadversedrugeventdatainhypertensionwithimplicationsoncovid19morbidity
AT jessicakawakami pulmonaryadversedrugeventdatainhypertensionwithimplicationsoncovid19morbidity
AT geraldjwyckoff pulmonaryadversedrugeventdatainhypertensionwithimplicationsoncovid19morbidity
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